<!--
To change this template, choose Tools | Templates
and open the template in the editor.
-->
<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN">
<html>
    <head>
        <meta http-equiv="Content-Type" content="text/html; charset=UTF-8">
        <title></title>
    </head>
    
    <body>

    <script type="text/javascript">
        function validate_required(field,alerttxt)
        {
            with (field)
            {
            if (value==null||value=="")
                {
                alert(alerttxt);return false;
                }
            else
                {
                return true;
                }
            }
        }
        
        function isNumeric(elem, helperMsg){
	var numericExpression = /^[0-9]+$/;
	if(elem.value.match(numericExpression)){
		return true;
	}else{
		alert(helperMsg);
		elem.focus();
		return false;
             }
        }




        function validate_form(thisform)
        {
            with (thisform)
            {
            if (validate_required(customername,"Name must be filled out!")==false)
            {customername.focus();return false;}
            if (validate_required(address,"Address must be filled out!")==false)
            {address.focus();return false;}
            if (validate_required(cardnumber,"CardNumber must be filled out!")==false)
            {cardnumber.focus();return false;}
            if (isNumeric(cardnumber,"CardNumber must be numeric!")==false)
            {cardnumber.focus();return false;}
            }

        }
    </script>



        
        <form name="feedbackForm" action="index.php" method="post"  onsubmit="return validate_form(this)" >
            <font color ="silver">
        NAME:
        </br>
        <input type="text" name="customername" />
        <br />
        ADDRESS:
        </br>
        <input type="text" name="address" />
        <br />
        <br />
        CARD NUMBER:
        </br>
        <input type="text" name="cardnumber">
        <br />
        <br />
        HOW WOULD YOU RATE THE SITE?
        <br />
        <input align="left" type="radio" name="rating" value="1-Star" /> 1-Star
        <br />
        <input align="left" type="radio" name="rating" value="2-Star" /> 2-Star
        <br />
        <input align="left" type="radio" name="rating" value="3-Star" /> 3-Star
        <br />
        <input align="left" type="radio" name="rating" value="4-Star" /> 4-Star
        <br />
        <input align="left" type="radio" name="rating" value="5-Star" /> 5-Star
        <br />
        <br />
        <input type="submit" name="submit" value="Submit"/>
        <br />
        <br />
        </font>
        </form>
        

       
        <?php
        // put your code here
        ?>
    </body>
</html>
